Wendy G Bourne, RN, CDE

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

RN066394 Issued in AZ

Practice address

77 W Forest Ave Ste 202
Flagstaff, AZ 86001-1483

Phone

(928) 214-3884

Fax

(928) 214-3981

NPI assigned

Oct 31, 2018

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1540944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540944000000",
    "number": "1265909816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 202",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011483",
            "telephone_number": "928-214-3884",
            "fax_number": "928-214-3981"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "77 W FOREST AVE STE 202",
            "city": "FLAGSTAFF",
            "state": "AZ",
            "postal_code": "860011483",
            "telephone_number": "928-214-3884",
            "fax_number": "928-214-3981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOURNE",
        "first_name": "WENDY",
        "middle_name": "G",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-10-31",
        "last_updated": "2018-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "AZ",
            "license": "RN066394",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Erica Boswell, RDH
• Suzanne Andry Botello, PHD, LPC
• Torey Botti, M.D.
• Julie Anne Bouck, PT, DPT
• Bevhion Beatrix Boudica, FNP
• Vanessa Bowden-Runge
• Jana Bowditch, CNM
• Matthew Greigory Bowe, RN
• Emilie Laura Bowers, FNP
• Rielly Boyd, PH.D.

• Registered Nurse in Flagstaff, AZ
• Providers in Flagstaff, AZ by specialty
• Registered Nurse in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.